• 대한교통학회지
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• 제25권6호
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• pp.65-77
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• 2007

양방향 좌회전차로(TWLTLs : Two-Way Left-Turn Lanes)는 도로중앙에 양방향의 좌회전 차량이 이용할 수 있는 연속진행형 좌회전 차로가 설치된 불균등차로 시스템의 한 형태로써, 접속밀도가 높고 좌회전 교통수요가 각 회전지 점별로 넓게 분산되어 있을 때 큰 운영 개선효과를 나타낼 수 있는 접근관리기법으로 알려져 있다. 본 연구에서는 양방향 좌회전차로의 국내 도입 가능성을 검토하기 위한 초기단계로써, 미시적 교통류 분석 시뮬레이션 모형인 VISSIM을 활용, 가상 네트워크와 실 네트워크에 대한 TWLTL 설치 전 후 모의실험을 수행하여 운영효율 및 안전성을 평가하였으며, 이를 기초로 설치준거를 제시하였다. VISSIM 모의실험 결과, 주도로의 직진 및 좌회전 이동류에 대한 상당수준의 지체감소를 확인하였으며, 교통 안전적으로도 큰 개선효과가 있었던 것으로 분석되었다. 본 연구는 국내에서 최초로 시뮬레이션 분석모형을 활용하여 양방향 좌회전차로의 운영효과 및 안전성 개선효과를 평가하고, 교통량 지체 안전도를 고려한 TWLTL의 설치준거를 제시하였다는 점에서 그 의의를 찾을 수 있을 것이다.

• Journal of Korean Neurosurgical Society
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• 제61권3호
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• pp.363-375
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• 2018

Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues. First, obtaining stable and reliable responses in children of different ages requires detailed understanding of normal age-adjusted brain-spine development. Neurophysiology, anatomy, and anthropometry of children are different from those of adults. Second, monitoring of the brain may include risk to eloquent functions and cranial nerve functions that are difficult with the usual neurophysiological techniques. Third, interpretation of signal change requires unique sets of normative values specific for children of that age. Fourth, tumor resection involves multiple considerations including defining tumor type, size, location, pathophysiology that might require maximal removal of lesion or minimal intervention. IOM techniques can be divided into monitoring and mapping. Mapping involves identification of specific neural structures to avoid or minimize injury. Monitoring is continuous acquisition of neural signals to determine the integrity of the full longitudinal path of the neural system of interest. Motor evoked potentials and somatosensory evoked potentials are representative methodologies for monitoring. Free-running electromyography is also used to monitor irritation or damage to the motor nerves in the lower motor neuron level : cranial nerves, roots, and peripheral nerves. For the surgery of infratentorial tumors, in addition to free-running electromyography of the bulbar muscles, brainstem auditory evoked potentials or corticobulbar motor evoked potentials could be combined to prevent injury of the cranial nerves or nucleus. IOM for cerebral tumors can adopt direct cortical stimulation or direct subcortical stimulation to map the corticospinal pathways in the vicinity of lesion. IOM is a diagnostic as well as interventional tool for neurosurgery. To prove clinical evidence of it is not simple. Randomized controlled prospective studies may not be possible due to ethical reasons. However, prospective longitudinal studies confirming prognostic value of IOM are available. Furthermore, oncological outcome has also been shown to be superior in some brain tumors, with IOM. New methodologies of IOM are being developed and clinically applied. This review establishes a composite view of techniques used today, noting differences between adult and pediatric monitoring.